Fri Nov 17 2023

90 articles - From Friday Nov 10 2023 to Friday Nov 17 2023

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Guidelines

Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…

Am J Gastroenterol

Diagnosis and Management of Biliary Strictures: A Clinical Practice Guideline Dissemination Tool.

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Clin Gastroenterol Hepatol

AGA Rapid Clinical Practice Update on the Management of Patients Taking GLP-1 Receptor Agonists Prior to Endoscopy: Communication.

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Meta-analysis

meta-analyses and systematic reviews

Endosc Int Open

Cold snare resection for non-ampullary sporadic duodenal adenomas: systematic review and meta-analysis.

Our meta-analysis suggests that CSP should be considered as the first-line therapy for NASDA.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Clinical trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome.

A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry ACTRN12620001362987.

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Hepatocellular carcinoma risk decreases as time accrues following hepatitis C virus eradication.

Among patients with cirrhosis and cured HCV infection, HCC risk declined progressively up to 6 years post-SVR-although it remained well above thresholds that warrant screening. This suggests that time since SVR can inform HCC surveillance strategies in patients with cured HCV infection and can be incorporated into HCC risk prediction models.

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Low liver fat in non-alcoholic steatohepatitis-related significant fibrosis and cirrhosis is associated with hepatocellular carcinoma, decompensation and mortality.

Low liver fat content in patients with burnt-out NASH-related significant fibrosis and cirrhosis is associated with an increase in hepatic decompensation, HCC and mortality.

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Trends in the prevalence rates and predictive factors of coeliac disease: A long-term nationwide follow-up study.

The nationwide prevalence of coeliac disease kept on rising from 2.12% in 2000 to 2.40% in 2011 in Finland. Positive TGA without EmA, TGA titres in the upper normal range and a pre-existing autoimmune disease predisposed to coeliac disease during the 10-year follow-up.

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Am J Gastroenterol

A clinico-pathologic comparison between early-onset and late-onset small bowel adenocarcinoma: a multicenter international study.

This difference is mainly due to the significantly higher prevalence of celiac disease among EO-SBA patients. EO-SBA is strongly associated with predisposing conditions, particularly with celiac disease, highlighting the importance of routine screening for celiac disease in EO-SBA patients.

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Antibiotics with or without Rifaximin for acute hepatic Encephalopathy in critically ill patients with cirrhosis: A double-blind, randomized controlled (ARiE) trial.

Reversal of overt HE in those on antibiotics was comparable to those on antibiotics+rifaximin.

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Changes in Therapy Are Not Associated with Increased Remission in Patients with Crohn's Disease of the Pouch.

Approximately 50% with symptoms at enrollment achieved clinical remission at 12 months, the majority of whom did so without a change in therapy.

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Comprehensive Assessment of Nutrition and Dietary Influences in Hypermobile Ehlers Danlos Syndrome (CANDI-hEDS) - a cross sectional study.

Altered diet is very common in the hEDS/HSD patients we studied and influenced by functional dyspepsia, reflux symptoms and ARFID. Those with ARFID have a four-fold increased risk of requiring nutrition support and therefore, it is paramount that psychological support is offered in parallel with dietary support in the management of DGBI in hEDS/HSD.

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Increased Grades of Rectal Intussusception: Role of Decline in Pelvic Floor Integrity and Association with Dyssynergic Defecation.

Our data suggests that decline in pelvic floor integrity with abnormal levator ani laxity is associated with increased RI grades; a process that is independent of age, history of vaginal deliveries and/or pelvic surgeries, and perhaps related to dyssynergic defecation.

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Patients with Esophageal Adenocarcinoma with prior GERD symptoms are similar to those without GERD: A Cross-sectional Study.

Esophageal adenocarcinoma patients with and without prior GERD symptoms are phenotypically similar, suggesting that BE screening efforts to prevent or detect early EAC should not be restricted to just those with GERD.

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Proportion Time Covered by Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis.

The proportion time covered by HCC surveillance in patients with cirrhosis remains low, highlighting a need for multi-level interventions.

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RACIAL DISPARITY IN ESOPHAGEAL SQUAMOUS CELL CARCINOMA TREATMENT AND SURVIVAL IN THE UNITED STATES.

Black individuals with ESCC have a lower survival than White individuals. This could be related to presenting at a later stage, but also disparities in which treatments they receive even among individuals with the same stage of disease. To what extent these disparities in receipt of treatment is due to structural racism, social determinants of health, implicit bias, or patient preferences deserves further study.

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Risk of Esophageal Cancer in Achalasia: A Matched Cohort Study Utilizing the Nationwide Veterans Affairs Achalasia Cohort (VA-AC).

Based on substantial EC risk, individuals with achalasia may benefit from a high index of suspicion and endoscopic surveillance for EC.

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Ten-day vonoprazan-amoxicillin dual therapy versus standard fourteen-day Bismuth-based quadruple therapy for first-line Helicobacter pylori eradication: a multicenter randomized clinical trial.

The 10-day VA-dual therapy provided satisfactory eradication rates of >90% (PP analysis), lower rates of adverse events compared with standard 14-day B-quadruple therapy as first-line H. pylori therapy. Trail registration number ChiCTR2300070100.

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Clin Gastroenterol Hepatol

A Composite Morphometric Duodenal Biopsy Mucosal Scale for Celiac Disease Encompassing both Morphology and Inflammation.

The composite VCIEL scale combining Vh Cd and IEL values appears to improve accuracy and statistical precision compared to either component alone.

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ENTERPRET: a randomized controlled trial of vedolizumab dose optimization in patients with ulcerative colitis who have early nonresponse.

In patients with early nonresponse and high drug clearance, vedolizumab dose optimization is probably not required. A proportion of patients benefited from continued treatment irrespective of the dose received. Number NCT03029143.

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Endosc Int Open

Cold snare polypectomy for duodenal adenomas in familial adenomatous polyposis: a prospective international cohort study.

CSP for (multiple) superficial non-ampullary duodenal adenomas in FAP seems feasible and safe. Long-term prospective research is needed to evaluate whether protocolized duodenal polypectomies prevent cancer and surgery.

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Cost-utility analysis of real-time artificial intelligence-assisted colonoscopy in Italy.

The implementation of AI detection tools in colonoscopy after patients test FIT-positive seems to be a cost-saving strategy for preventing CRC incidence and mortality.

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Long-term results after EUS gallbladder drainage in high-surgical-risk patients with acute cholecystitis: A 3-year follow-up registry.

Late LAMS-RAEs tend to be more asymptomatic over time. Symptomatic LAMS-RAEs are associated with gastric location, and overall, AEs tend to recur.

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Preferred techniques for endoscopic ultrasound-guided gastroenterostomy: a survey of expert endosonographers.

Significant variation in performance technique for EUS-GE exists among expert US endoscopists, which may hinder widespread adoption and contribute to inconsistencies in reported patient outcomes. The granularity provided by these survey results may identify areas to focus standardization efforts and guide future studies on developing an ideal EUS-GE protocol.

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Endoscopy

Device-assisted enteroscopy performance measures in the United Kingdom: DEEP-UK quality improvement project.

Performance measures for DAE in the UK meet the ESGE quality benchmarks, with high diagnostic and therapeutic yields, and a low incidence of major adverse events. However, there is room for improvement in optimizing sedation practices, standardizing the depth of insertion documentation, and adopting marking techniques to aid in the follow-up of detected lesions.

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Improvement of adenoma detection rate by two computer-aided colonic polyp detection systems in high adenoma detectors: A randomized multi-center trial.

Even in high adenoma detectors, CADes significantly improved ADR and APC. The AADR tended to be improved by both systems, and this may enhance colorectal cancer prevention.

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Gastrointest Endosc

Aspirin exposure and its association with metal stent patency in malignant biliary obstruction: a large international multicenter propensity score-matched study.

In this large, multicenter study utilizing propensity score-matching, chronic exposure to ASA did not protect against stent dysfunction in MDBO. Instead, the analysis revealed that the etiology of pancreatic cancer was an independent predictor of stent dysfunction while cancer therapy was protective.

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Association between time from esophageal food impaction to endoscopy and adverse events.

Since time from EFI event to EGD is not associated with adverse events, emergent EGD for EFI may be unnecessary and other considerations may determine EGD timing.

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Automatically optimized radiomics modeling system for small gastric submucosal tumors (<2cm) discrimination based on endoscopic ultrasound images.

The AORMS implements automatic parameter selection, which enhances its robustness and clinical applicability. It has demonstrated good performance in the diagnosis and risk stratification of GISTs, which could aid endoscopists in the diagnosis of small gastric SMTs (<2cm).

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Colonic-enteric Lumen-Apposing Metal stents: A Promising and Safe Alternative for Endoscopic Management of Small Bowel Obstruction.

This study highlights that EUS-CE with LAMS can be performed with high technical and clinical success for the management of SBO, particularly in patients with malignant obstructions who are not suitable candidates for surgical interventions. Further research with larger sample sizes will be essential to substantiate its efficacy and safety.

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Endoscopic Papillectomy for Ampullary Lesions of minor papilla.

EP is safe and effective in AL of the minor duodenal papilla. Such lesions could be managed according to guidelines for EP of major duodenal papilla.

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Outcomes of endoscopic submucosal dissection for esophageal cancer with segmental absence of intestinal musculature.

SAIM is a very rare condition, which is usually only diagnosed during ESD. Physicians performing esophageal ESD should be aware about SAIM. When SAIM is detected, the ESD technique should be modified to prevent full-thickness perforation.

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Gut

Chimeric antigen receptors of HBV envelope proteins inhibit hepatitis B surface antigen secretion.

CARs possess direct antiviral activity, besides the well-known application in T-cell therapy. Fc attached G12-scFv and G12-CARs could provide a novel approach for reducing circulating HBsAg.

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Novel insights into causal effects of serum lipids and lipid-modifying targets on cholelithiasis.

Furthermore, we estimated the causal associations of the genetically predicted serum lipids with cholelithiasis in Europeans using the Mendelian randomisation (MR) design. Finally, both drug-target MR and colocalisation analyses were performed to estimate the lipid-modifying targets' effects on cholelithiasis, including inhibitors should prevent its risk.

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Spatial transcriptomics reveals a low extent of transcriptionally active hepatitis B virus integration in patients with HBsAg loss.

Transcriptionally active HBV integration occurred in chronically HBV-infected patients at different phases, including in patients with HBsAg loss. Antiviral treatment was associated with a decreased number and extent of transcriptionally active viral integrations, implying that early treatment intervention may further reduce the number of viral integration events.

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Hepatology

A Public health perspective on mitigating the global burden of chronic liver disease.

Guided by the framework, we review examples of federal/state, community, and individual-level interventions with the potential to address these determinants of SLD. Ultimately, mitigating SLD's burden requires primary risk factor reduction at multiple socioecological levels, by scaling up the World Health Organization's "best buys", in addition to developing and implementing SLD specific control interventions.

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Alcohol induced epigenetic changes prevent fibrosis resolution after alcohol cessation in mice.

In summary, KDM5B and KDM5C demethylases prevent liver fibrosis resolution after alcohol cessation in part through suppression of LXR activity.

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Benefit and harm of waiting time in liver transplantation for HCC.

Enhancing our understanding of HCC tumor biology through the analysis of subtypes and molecular genetics holds significant promise in advancing the personalized approach for patients. In this review, the effect of waiting time duration on outcome in patients with HCC enlisted for LT is discussed.

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Immunogenomics of cholangiocarcinoma.

Functionally uncoupling the tumor-promoting or tumor-suppressing roles of immune profiles will be critical for identifying new immunomodulatory treatment strategies and associated biomarkers for patient stratification. This review will discuss the immunogenomics of cholangiocarcinoma, including the impact of genomic alterations on immune functionality, subversion of the cancer-immunity cycle, as well as clinical implications for existing and novel treatment strategies.

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MicroRNA-206-3p suppresses hepatic lipogenesis and cholesterol synthesis while driving cholesterol efflux.

MiR-206, through differentially modulating LXRa signaling in hepatocytes and macrophages, inhibits DNL, promotes cholesterol efflux, and concurrently hinders cholesterol synthesis and VLDL production. MiR-206 simulates the functions of lipid-lowering medications, statins and LXRa agonists.

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Single-cell dissection of the multicellular ecosystem and molecular features underlying microvascular invasion in hepatocellular carcinoma.

This study provides a comprehensive single-cell atlas of MVI in HCC, shedding light on the complex multicellular ecosystem and molecular features associated with MVI. These findings deepen our understanding of the underlying mechanisms driving MVI and provide valuable insights for improving clinical diagnosis and developing more effective treatment strategies.

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J Hepatol

An engineered Escherichia coli Nissle strain prevents lethal liver injury in a mouse model of tyrosinemia type 1.

This is the first report of an engineered live bacterium that can degrade tyrosine and alleviate lethal liver injury in mice with HT1. EcN-HT represents a novel engineered probiotic with the potential to treat this condition. Impact and implications Patients with hereditary tyrosinemia type 1 (HT1) is characterized by an inability to metabolize tyrosine normally and suffer from liver failure, renal dysfunction, neurological impairments, and cancer. Given the overlap and complementarity between the host and microbial metabolic pathways, the gut microbiome provides a potential chance to regulate host metabolism through degradation of tyrosine and reduction of byproducts that might be toxic. Here, we demonstrated that an engineered live bacterium, EcN-HT, could enhance tyrosine breakdown, reduce the accumulation of toxic tyrosine byproducts, and protect against lethal liver injury in Fah-knockout mice. These findings suggested that engineered live biotherapeutics that can degrade tyrosine in the gut may represent a viable and secure strategy for the prevention of lethal liver injury in HT1 as well as the mitigation of its associated pathologies.

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Characteristics and outcomes of immunotherapy-related liver injury in patients with hepatocellular carcinoma versus other advanced solid tumours.

Despite higher incidence and earlier onset in patients with HCC, IrLI is characterised by high rates of remission, low requirement for corticosteroid therapy and low risk of decompensation compared to other solid tumours. Hepatotoxicity leads to discontinuation in 7% of patients with HCC and does not negatively affect oncological outcomes. Impact and implications Immune-related liver injury (irLI) is common in patients with cancer receiving immune checkpoint inhibitors (ICI), but whether irLI is more frequent or it is associated with a worse clinical course in patients with hepatocellular carcinoma (HCC), compared to other tumours, is not known. Herein, we compared characteristics and outcomes of irLI in two prospective cohorts including patients treated with ICIs for HCC or for other oncological indications. irLI is significantly more common and it occurs earlier in patients with HCC, also after adjustment for duration of treatment exposure. However, outcomes of patients with HCC who developed irLI are not negatively affected in terms of requirement of corticosteroid therapy, hepatic decompensation, treatment discontinuation and overall survival.

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Convergent MAPK pathway alterations mediate acquired resistance to FGFR inhibitors in FGFR2 fusion-positive cholangiocarcinoma.

These findings suggest convergent genomic evolution in the MAPK pathway may be a potential mechanism of acquired resistance to FGFRi. Impact and implications We evaluated tumors and plasma from patients who previously received inhibitors of Fibroblast Growth Factor Receptor (FGFR), an important receptor that plays a role in cancer cell growth, especially in tumors with abnormalities in this gene such as FGFR fusions, where the FGFR gene is fused to another gene, leading to activation of cancer cell growth. We found that patients treated with FGFR inhibitors may develop mutations in other genes such as KRAS, and this can confer resistance to FGFR inhibitors. Clinical trial number NCT02052778.

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Single cell-resolved study of advanced murine MASH reveals a homeostatic pericyte signaling module.

In our current single cell-resolved study of advanced murine MASH we identified a quiescence-associated hepatic stellate cell-signaling module with potential to preserve normal sinusoid function. As expression levels of its constituents are conserved in the human liver, the signaling module may be amenable to therapeutic stimulation for restoration of sinusoid function in chronic liver disease.

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J Neurogastroenterol Motil

Roles of Cytokines in Pathological and Physiological Gastroesophageal Reflux Exposure.

"Microinflammation" in physiological acid exposure groups indicate that even a mild trigger is sufficient for the initiation and progression of inflammatory activity. Additionally, the anti-inflammatory cytokines were highly increased. The results may have a potential role in the treatment of heartburn symptoms and healing of the mucosa.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Gastroenterology

Integrating Evidence to Guide Use of Biologics and Small Molecules for Inflammatory Bowel Diseases.

In this review we provide a framework for clinicians and researchers to understand key differences in sources of evidence, how different methodologies are applied to study the comparative effectiveness of advanced medical therapies in IBD, and considerations for how these sources of evidence can be used to better integrate current guideline recommendations. Over time, we anticipate this framework will allow for a transition to living guidelines and/or practice recommendations.

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Gut

Gut virome in inflammatory bowel disease and beyond.

The field of gut virome is progressively expanding, thanks to the advancements of sequencing technologies and bioinformatic pipelines. These have contributed to a better understanding of how virome dysbiosis is linked to intestinal disease pathogenesis and how the modulation of virome composition may help the clinical intervention to ameliorate gut disease management.

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Miscellaneous

misc publications eg case reports, tools of the trade, images of the month, etc…

Am J Gastroenterol

Emergency pancreatic pseudocyst exploration to retrieve a stent: a nerve-wracking migration.

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Gastric signet-ring cell carcinoma with multiple colorectal metastases.

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Gelée blanche.

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Inverted Pyloric Gland Adenoma of the Duodenum.

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Quality Improvement for Health Care Providers in Gastroenterology and Hepatology.

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Video Endoscopy as Big Data: Balancing Privacy and Progress in Gastroenterology.

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Clin Gastroenterol Hepatol

Endoscopic transcecal appendectomy with a novel detachable over-the-scope clip.

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Peripheral blood IL5RA gene expression as a diagnostic biomarker for eosinophilic esophagitis.

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Prevalence of Steatotic Liver Disease (MASLD, MetALD and ALD) in the United States: NHANES 2017-2020.

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Endosc Int Open

Successful removal of a fractured pancreatic stent using a novel thin-tapered drill dilator.

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Endoscopy

Combination of endoscopic full-thickness resection and laparoscopic intragastric surgery for gastric submucosal tumor.

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Efficacious resolution of a rectal subepithelial cold abscess via endoscopic submucosal excavation.

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Emergency rescue esophageal stenting through retrograde and antegrade rendezvous gastroscopy for an iatrogenic complicated esophageal perforation.

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Endoscopic clipping-assisted endoscopic injection sclerotherapy in the treatment of esophageal varices.

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Endoscopic on-site characterization of a large excavated lesion in longstanding ulcerative colitis using a novel bioinformatic tool.

Pubmed   Journal   ReadQx   PMC

Endoscopic ultrasound-guided choledochoduodenostomy: is the rate of stent dysfunction underestimated?

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Gastritis cystica profunda mimicking submucosal tumor.

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Novel pancreatoscope improves diagnostic yield of visual findings for intraductal papillary mucinous neoplasms.

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Percutaneous endoscopic peritoneal biopsy for a patient with unexplained ascites.

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Pursestring encirclement before endoscopic submucosal excavation of a cecal submucosal tumor.

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Gastroenterology

A Rare Cause of Duodenal ulcer.

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A Seemingly Benign Pancreatic Cyst With an Unsettling Trend of Enlarging Size and Associated Symptoms.

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An overlooked cause of severe gastritis.

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Helicobacter pylori genetic variations: A driver of gastric cancer progression?

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Medicaid Expansion States See Long-Term Improvement in Colorectal Cancer Screening Uptake Among Low-Income Individuals.

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NAFLD Gets Renamed as MASLD: Progress but with Challenges.

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PNPLA3 risk allele association with ALT response to semaglutide treatment.

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Time-Restricted Eating for Weight Loss: The Jury Is Still Out.

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Hepatology

Fellows' Corner.

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Hepatocytes of mice and men: Different regenerative signals?

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Introducing the Editorial Fellow and the Fellows' Corner.

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Letter to the Editor: Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome: First report of the IAIHG retrospective registry.

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Reply - Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome: first report of the IAIHG retrospective registry.

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Reply: Alcohol-induced extracellular ASC specks perpetuate liver inflammation and damage in alcohol-associated hepatitis even after alcohol cessation.

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J Hepatol

In memoriam: Hanns-Ulrich Marschall (1954-2023).

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Letters&Replies

Letters to the editors and authors’ replies

Clin Gastroenterol Hepatol

AI-Powered Patient Education for Comprehensive and Individualized Understanding for Patients.

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Bridging the Gap: Unraveling the Complex Ties between Digestive Diseases and Mental Health in the Elderly.

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Gastroenterology

Regarding the AGA Clinical Practice Update on Exocrine Pancreatic Insufficiency (EPI).

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Residual confounding in the associations between genetic ancestry categories and outcomes.

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Time to include IBD as a notifiable disease?

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Gut

Practical approach to interpretation of 48-hour wireless pH-monitoring studies.

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J Hepatol

Current evidence on the beneficial HOPE-effect based on systematic reviews and meta-analyses in liver transplantation.

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Stop using the misidentified cell line - LO2 as a human hepatocyte.

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